Pretransplant Evaluations and Evidence-Based Education

Kidney transplant is a complicated process involving multiple regulatory and oversight organizations, transplant centers, providers from different specialties, and, importantly, the family. Families are required to participate in a thorough evaluation prior to being listed for transplant or receiving a transplant. In addition to determining the medical appropriateness of kidney transplantation, the pretransplant evaluation assesses the child’s and family’s understanding, motivation, and medical/psychosocial readiness to pursue transplant and endure possible complications, challenges, and changes that arise in the posttransplant period. Additionally, the pretransplant evaluation is an opportunity for families to learn about transplant and receive information that allows them to make well-informed decisions for their child. This chapter gives details about key players (both organizations and individuals) in the transplant process, describes what families can expect during the pretransplant evaluation and after, and provides information about the types of decisions and issues families may face. Ultimately, a successful transplant is a collaborative effort, and the goal of the evaluation is to ensure that a family has access to the resources and support necessary for successful posttransplant outcomes.